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PubMed2002

Virtual power based algorithm for decoupling large motions from infinitesimal strains: application to shoulder joint biomechanics.

New trends of numerical models of human joints require more and more computation of both large amplitude joint motions and fine bone stress distribution. Together, these problems are difficult to solve and very CPU time consuming. The goal of this study is to develop a new method to diminish the calculation time for this kind of problems which include calculation of large amplitude motions and infinitesimal strains. Based on the Principle of Virtual Power, the present method decouples the problem into two parts. First, rigid body motion is calculated. The bone micro-deformations are then calculated in a second part by using the results of rigid body motions as boundary conditions. A finite element model of the shoulder was used to test this decoupling technique. The model was designed to determine the influence of humeral head shape on stress distribution in the scapula for different physiological motions of the joint. Two versions of the model were developed: a first version completely deformable and a second version based on the developed decoupling method. It was shown that biomechanical variables, as mean pressure and von Mises stress, calculated with the two versions were sensibly the same. On the other hand, CPU time needed for calculating with the new decoupled technique was more than 6 times less than with the completely deformable model.

Algorithms↗
PubMed2000

[Prognostically relevant factors in treatment of the post-traumatic unstable shoulder joint].

The purpose of this prospective study was to determine concomittant lesions of glenohumeral dislocation and their correlation with the outcome, to determine the influence of various stabilizing operation techniques on the outcome. 106 shoulders [104 patients, 81 men, 23 women, mean age 36 (16-83) years] operated because of shoulder instability after at minimum one shoulder luxation between 1988 to 1995 were evaluated 3 years (0.8-8 years) postoperatively using Constant score. Preoperative arthroscopy was performed to document intraarticular lesions. There were 7 reluxations (5 because of a new accident), mostly after Putti-Platt procedures. The average modified Constant Score was 66 (10-85) points (maximum 85). 29 patients (27%) had less than 60 points, mostly because of pain and restriction of function, and were evaluated as poor. Lesions of rotator cuff, long biceps tendon and subscapularis tendon had a bad prognosis. The severity of arthroscopically found lesions correlated with the outcome. Operations with shortening of subscapularis tendon or using a bone graft gave bad results. Anatomic reconstruction of the labrum-ligament complex in combination with a plasty of the extended capsule gave best results. Preoperative arthroscopy can determine the extent of different lesions after shoulder luxation which influence the outcome and is useful to select the optimal operation technique.

Adolescent↗